Dulani Beneragama

Drinking water in areas with a high prevalence of chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka is known to have high concentrations of fluoride and hardness. The present study evaluated the individual and combined effects of water hardness and fluoride on potential nephrotoxicity, using Wistar rats as an animal model. Thirty-five Wistar rats were randomly assigned into five groups (n=7). Test groups F, H, RL, and RH were given de-ionized water containing 1.5 mg/L fluoride, 200 mg/L hardness, 1.5:200 mg/L fluoride: hardness, and 5:800 mg/L fluoride: hardness respectively, while control group C was given de-ionized water. Body weight and daily water consumption were measured. Serum creatinine, urine creatinine, and urinary biomarker KIM-1 were analyzed. Histopathological changes in the kidneys were observed. There were no significant differences in body weights (p>0.05) while daily water consumption was reduced significantly in the test groups RL and RH (p<0.0...

Accessory spleen is a relatively common occurrence. However, an intrapancreatic accessory spleen can get hypertrophied following splenectomy and rarely mimic a pancreatic neoplasm leading to misdiagnosis. Here we present a 64-year-old male who had undergone left radical nephrectomy and splenectomy for renal cell carcinoma 14 years back, presenting with upper abdominal discomfort. He was found to have a mass in the pancreatic tail on imaging, suggesting an intrapancreatic neoplastic lesion. After a multidisciplinary team decision based on contrast-enhanced computed tomography and magnetic resonance imaging, he underwent an uncomplicated distal pancreatectomy, and the histology revealed an intrapancreatic accessory spleen. Contrast-enhanced computed tomography, magnetic resonance imaging, and positron emission tomography alone is not specific enough to confidently differentiate an accessory spleen preoperatively. Nuclear scintigraphy fused with contrast-enhanced computed tomography pr...

BackgroundInflammatory myofibroblastic tumour is a rare neoplasm with a potential to behave in a malignant manner. It can occur anywhere in the body, however involvement of the head, especially the para-nasal sinuses is rare.Case presentationA 33-year-old South Asian male presented with coryzal symptoms including a persistent cough with an asymmetrical swelling of the left side of the face. Imaging revealed a mass lesion involving the para-nasal sinuses eroding into the orbit. Histology and the clinical picture were compatible with inflammatory myofibroblastic tumour. As curative excision of the tumour was not feasible, medical management was offered. Despite early features of remission to glucocorticoids, tapering resulted in recurrence. Hence combination therapy with glucocorticoids and methotrexate was commenced with dramatic reduction of tumour burden and the patient has been in remission to date.ConclusionInflammatory myofibroblastic tumour has the potential to behave in a mali...